Ophthalmology and Therapy最新文献

{"title":"Performance and Safety of a Sodium Hyaluronate, Xanthan Gum, and Osmoprotectants Ophthalmic Solution in the Treatment of Dry Eye Disease: An Observational Clinical Investigation.","authors":"Mercedes Molero Senosiaín, Barbara Burgos-Blasco, Pilar Perez-García, Álvaro Sánchez-Ventosa, Marta Villalba-González, María Dolores López Pérez, José Carlos Díaz, Vanesa Díaz-Mesa, Alberto Villarrubia Cuadrado, Enrique Artiaga Elordi, Jose Manuel Larrosa Poves, Alejandro Blasco, Antonio Mateo, Claudine Civiale, Laura Bonino, Antonio Cano-Ortiz","doi":"10.1007/s40123-025-01099-x","DOIUrl":"10.1007/s40123-025-01099-x","url":null,"abstract":"<p><strong>Introduction: </strong>Dry eye disease (DED) is characterized by an imbalance in the tear film, resulting in symptoms such as dryness, redness, and discomfort. The management of DED involves tear supplements, medications, or surgery in severe cases. To evaluate the clinical performance and safety of a hypotonic ophthalmic solution containing sodium hyaluronate 0.2%, xanthan gum 0.2%, and osmoprotectants (glycine and betaine) for treating DED.</p><p><strong>Methods: </strong>This multicenter, prospective, observational clinical investigation included 35 subjects treated with one drop of the ophthalmic solution four times daily. Evaluations were conducted at baseline, on day 14, and at 1 and 3 months. The investigation assessed corneal and conjunctival fluorescein staining (NEI score), hyperemia index (Keratograph®), fluorescein tear film break-up time (TFBUT), best-corrected visual acuity, dry eye symptoms (SANDE), and quality of life (DEQS). Safety was monitored through adverse events, intraocular pressure measurements, and the Investigator Global Assessment of Safety.</p><p><strong>Results: </strong>Subjects were predominantly female (93.9%), with an average age of 59.9 ± 13.8 years. The ophthalmic solution significantly reduced keratitis lesions with global NEI score decreasing from baseline at 1 month (- 6.67 ± 4.6, p = 0.001) and 3 months (- 7.61 ± 4.0 points; p = 0.001). Conjunctival hyperemia improved significantly after 1 month (- 0.34 ± 0.7 points; p = 0.027), while fluorescein tear film stability increased significantly at 1 (1.85 ± 3.1 s; p = 0.002) and 3 months (1.98 ± 3.4 s; p = 0.001). Symptoms also improved significantly (p = 0.001) at 1 and 3 months (- 29.37 ± 22.2 points and - 26.41 ± 24.0 points, respectively), as did quality of life (- 20.81 ± 15.6 points at 1 month and - 18.43 ± 19.3 points at 3 months; p = 0.001 for both). The safety profile was very good, with no adverse events (only mild ocular discomfort reported in 14.3% of subjects).</p><p><strong>Conclusions: </strong>The ophthalmic solution effectively improved DED symptoms and signs, enhancing patients' quality of life while maintaining a good safety profile.</p><p><strong>Trial registration number: </strong>NCT05778942.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"675-692"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular Sticks for Routine Ophthalmic Surgery: A Randomized Controlled Monocentric Trial.","authors":"Isaak Fischinger, Manfred Tetz, Angela Odame, Heidi Kulas, Martin Abel","doi":"10.1007/s40123-025-01107-0","DOIUrl":"10.1007/s40123-025-01107-0","url":null,"abstract":"<p><strong>Introduction: </strong>Ocular sticks are used to absorb fluids during ophthalmic surgeries. Hence, this prospective study was conducted to evaluate the clinical performance, safety, and usability of Pro-optha^® Ocular Sticks in comparison to an alternative device under the conditions of routine ophthalmic surgeries.</p><p><strong>Methods: </strong>Patients requiring eye surgery were randomly allocated into two equal groups, with the investigational device, Pro-ophta^® Ocular Sticks, as the intervention group (IG) and the alternative stick as the comparator group (CG). Two types of surgery were performed. The study is also registered on the German Clinical Trials Register with ID DRKS00025690.</p><p><strong>Results: </strong>106 patients were included in the analyses. In both treatment groups, the investigator's/surgeon's general user satisfaction was rated as either \"good\" or \"very good.\" The non-inferiority hypothesis that the Pro-ophta^® Ocular Stick is not rated worse in satisfaction than the alternative device was confirmed with statistical significance (p = 0.0005). At least 98.12% were rated as \"good\" and \"very good\" in both treatment groups for the additional endpoints. Pro-ophta^® Ocular Stick was rated better for almost all the additional endpoints and within the surgery subgroups. The mean number of sticks and surgery duration were 3.5 ± 2.74 and 11.5 (± 8.88) min, respectively, with a positive correlation (r = 0.580) for the Pro-ophta^® Ocular Stick and 3.9 ± 2.45 and 9.5 (± 5.90) min, respectively, with a positive correlation (r = 0.025) for the alternative device. No device-related adverse events occurred.</p><p><strong>Conclusions: </strong>Effective ocular sticks play an instrumental role in the outcome of ophthalmic surgeries. The investigational device demonstrated efficiency, yielding good surgical results, usability, and an exceptionally good safety profile.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"659-673"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Advances in AI-Assisted Analysis of Fundus Fluorescein Angiography (FFA) Images: From Detection to Report Generation.","authors":"Tao Yu, An Shao, Hongkang Wu, Zichang Su, Wenyue Shen, Jingxin Zhou, Xingxi Lin, Danli Shi, Andrzej Grzybowski, Jian Wu, Kai Jin","doi":"10.1007/s40123-025-01109-y","DOIUrl":"10.1007/s40123-025-01109-y","url":null,"abstract":"<p><p>Fundus fluorescein angiography (FFA) serves as the current gold standard for visualizing retinal vasculature and detecting various fundus diseases, but its interpretation is labor-intensive and requires much expertise from ophthalmologists. The medical application of artificial intelligence (AI), especially deep learning and machine learning, has revolutionized the field of automatic FFA image analysis, leading to the rapid advancements in AI-assisted lesion detection, diagnosis, and report generation. This review examined studies in PubMed, Web of Science, and Google Scholar databases from January 2019 to August 2024, with a total of 23 articles incorporated. By integrating current research findings, this review highlights crucial breakthroughs in AI-assisted FFA analysis and explores their potential implications for ophthalmic clinical practice. These advances in AI-assisted FFA analysis have shown promising results in improving diagnostic accuracy and workflow efficiency. However, further research is needed to enhance model transparency and ensure robust performance across diverse populations. Challenges such as data privacy and technical infrastructure remain for broader clinical applications.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"599-619"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Disease Activity Criteria on Extending Injection Intervals in Real-World Patients with Neovascular Age-Related Macular Degeneration.","authors":"Bhairavi Bhatia, Sing Yue Sim, Evangelia Chalkiadaki, Georgios Koutsocheras, Luke Nicholson, Senthil Selvam, Sobha Sivaprasad, Bishwanath Pal, Josef Huemer, Pearse A Keane, Robin Hamilton, Praveen J Patel","doi":"10.1007/s40123-025-01108-z","DOIUrl":"10.1007/s40123-025-01108-z","url":null,"abstract":"<p><strong>Introduction: </strong>In clinical practice, intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection intervals for patients with neovascular age-related macular degeneration (nAMD) are based on disease activity, with active or recurrent disease requiring more frequent injections. Injection interval modification criteria differ from those used in clinical trials, thereby potentially affecting treatment outcomes. This analysis evaluated the potential impact of applying disease activity criteria from recent clinical trials (TENAYA/LUCERNE; HAWK/HARRIER; PULSAR) on the decision to extend injection intervals in real-world patients commenced on faricimab after the loading phase of treatment and at 12 months.</p><p><strong>Methods: </strong>Data were analysed from 105 treatment-naïve patients with nAMD who received anti-VEGF injections at Moorfields Eye Hospital. Disease activity criteria from TENAYA/LUCERNE, HAWK/HARRIER and PULSAR clinical trials were applied to determine the hypothetical impact on the decision to modify injection intervals at week 12 (fourth injection) and 12-month real-world clinic visits.</p><p><strong>Results: </strong>At 12 weeks, 79% of patients had injection intervals extended in clinical practice compared to 80% when applying hypothetical TENAYA/LUCERNE disease activity criteria; 77% using HAWK/HARRIER and 96% using PULSAR. There was agreement between clinical practice and all clinical trials in 60% of eyes, and no agreement in 13%. At 12 months, fewer patients were inactive, with 55% of eyes quiescent in clinical practice, 58% when applying TENAYA/LUCERNE criteria and 67% using HAWK/HARRIER. Application of PULSAR disease activity criteria showed 96% of patients were classed as inactive. 34% of eyes showed agreement in disease activity status between clinical practice and all clinical trials at 12 months, with no agreement in 20%.</p><p><strong>Conclusions: </strong>Applying disease activity criteria from clinical trials to clinical practice can have a significant impact on hypothetical anti-VEGF injection intervals. Consideration should be paid to which criteria are used in real-world practice to help achieve treatment burden reductions and optimal treatment outcomes seen in clinical trials.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"773-786"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hydroxypropyl-Methylcellulose and GlicoPro^® Eyedrops in the Treatment of Dry Eye Disease: In Vitro and Clinical Study.","authors":"Edoardo Villani, Giuseppe Campagna, Valentina Gentili, Elisa Imelde Postorino, Paola Genovese, Paola Palino, Gloria Maini, Alice Carbucicchio, Eleonora Ferioli, Paolo Nucci, Roberta Rizzo, Pasquale Aragona","doi":"10.1007/s40123-025-01101-6","DOIUrl":"10.1007/s40123-025-01101-6","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial tear substitutes are key elements in the first-line treatment of dry eye disease (DED). We hypothesized that GlicoPro^®, a new multimolecular complex based on proteins, sulfured and unsulfured glycosaminoglycans and opiorphin, was able to significantly improve the effect of hydroxypropyl-methylcellulose (HPMC) eyedrops in treating DED.</p><p><strong>Methods: </strong>We performed an in vitro experiment and a clinical study, comparing an HPMC + GlicoPro^®-based to an HPMC-based ophthalmic formulation (similar kinematic viscosity and comparable HPMC concentration). An in vitro dry eye model was established by inducing hyperosmolarity in the base medium of human corneal epithelial cells HCE-2. After treatment with ophthalmic formulations, the expression levels of inflammatory cytokines and enzymes (IL-20, IL-1β, TNF-α, IL-6, IL-8, MMP-9, and MCP-1) was measured by real-time polymerase chain reaction. Moreover, we performed a single-blind randomized 1:1 clinical trial, aimed to compare the efficacy of the two formulations instilled four times per day (QID), in treating mild-to-moderate DED. Symptoms (Ocular Surface Disease Index and Symptom Assessment iN Dry Eye), clinical signs, and ocular surface imaging data were assessed at baseline and after 1 and 3 months of treatment.</p><p><strong>Results: </strong>In vitro experiment: under hyperosmotic conditions, corneal epithelial cells upregulated the expression of inflammatory cytokines IL-20, IL-1β, TNF-α, IL-6, and IL-8. Treatment with HPMC + GlicoPro^® significantly decreased the expression of all inflammatory markers tested, including cytokines, MMP-9, and MCP-1 (P < 0.05).</p><p><strong>Clinical study: </strong>the HPMC + GlicoPro^® formulation showed a significantly higher effect in improving symptoms (overall treatment effect: P < 0.001), tear film stability, and markers of inflammation on corneal confocal microscopy (P < 0.01).</p><p><strong>Conclusions: </strong>Both in vitro and clinical data provided evidence supporting the role of GlicoPro^® in improving the effect of HPMC in DED treatment.</p><p><strong>Clinical trial registration: </strong>NCT06726525.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"787-803"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Efficacy of Large Language Models in Guiding Treatment Decisions for Pediatric Refractive Error.","authors":"Daohuan Kang, Hongkang Wu, Lu Yuan, Wenyue Shen, Jia Feng, Jiao Zhan, Andrzej Grzybowski, Wen Sun, Kai Jin","doi":"10.1007/s40123-025-01105-2","DOIUrl":"10.1007/s40123-025-01105-2","url":null,"abstract":"<p><strong>Introduction: </strong>Effective management of pediatric myopia, which includes treatments like corrective lenses and low-dose atropine, requires accurate clinical decisions. However, the complexity of pediatric refractive data, such as variations in visual acuity, axial length, and patient-specific factors, pose challenges to determining optimal treatment. This study aims to evaluate the performance of three large language models in analyzing these refractive data.</p><p><strong>Methods: </strong>A dataset of 100 pediatric refractive records, including parameters like visual acuity and axial length, was analyzed using ChatGPT-3.5, ChatGPT-4o, and Wenxin Yiyan, respectively. Each model was tasked with determining whether intervention was needed and subsequently recommending a treatment (eyeglasses, orthokeratology lens, or low-dose atropine). The recommendations were compared to professional optometrists' consensus, rated on a 1-5 Global Quality Score (GQS) scale, and evaluated for clinical safety utilizing a three-tier accuracy assessment.</p><p><strong>Results: </strong>ChatGPT-4o outperformed both ChatGPT-3.5 and Wenxin Yiyan in determining intervention needs, with an accuracy of 90%, significantly higher than Wenxin Yiyan (p < 0.05). It also achieved the highest GQS of 4.4 ± 0.55, surpassing the other models (p < 0.001), with 85% of responses rated as \"good\" ahead of ChatGPT-3.5 (82%) and Wenxin Yiyan (74%). ChatGPT-4o made only eight errors in recommending interventions, fewer than ChatGPT-3.5 (12) and Wenxin Yiyan (15). Additionally, it performed better with incomplete or abnormal data, maintaining higher quality scores.</p><p><strong>Conclusion: </strong>ChatGPT-4o showed better accuracy and clinical safety, making it a promising tool for decision support in pediatric ophthalmology, although expert oversight is still necessary.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"705-716"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular Manifestations and Pathological Features in Goldenhar Syndrome: A 10-Year Retrospective Study.","authors":"Fei Fang, Tingxi A, Siyi Zhang, Liangbo Chen, Junzhao Chen, Yang Lu, Chunyi Shao, Yao Fu","doi":"10.1007/s40123-025-01100-7","DOIUrl":"10.1007/s40123-025-01100-7","url":null,"abstract":"<p><strong>Introduction: </strong>This study characterized the ocular manifestations and associated pathological features in a large cohort of patients diagnosed with Goldenhar syndrome (GS).</p><p><strong>Methods: </strong>Patients diagnosed with GS at the Department of Ophthalmology at Shanghai Ninth People's Hospital between 2014 and 2023 were retrospectively identified. Each patient underwent a standardized ophthalmological assessment and relevant tests. Epibulbar choristomas and eyelid colobomas were further categorized into different clinical groups, and their incidence rates and associated pathological features were evaluated.</p><p><strong>Results: </strong>A total of 72 patients diagnosed with GS (98 affected eyes) were included. The most prevalent ocular manifestations were epibulbar choristoma (94.44%) and upper eyelid coloboma (50%). Epibulbar choristomas were classified into four groups, with group II epibulbar choristomas being the most common (29.79%). The pathological features of the epibulbar choristomas varied significantly with location (p < 0.001): the choristomas located at the limbus were all dermoids (100%); lipodermoid was the most prevalent type located at the conjunctiva (40%); and dermoid was the predominant type of choristoma involving both the limbus and conjunctiva (50%), followed by lipodermoid (27.27%) and complex choristoma (22.73%). Upper eyelid colobomas were predominantly unilateral, with mild, moderate, and severe defects in 32.5%, 52.5%, and 15% of the cases, respectively. There was a significant coincidence and severity association between upper eyelid colobomas and epibulbar choristomas (p < 0.05).</p><p><strong>Conclusions: </strong>Our study represents the largest reported case series of GS to date and highlights the prevalence of epibulbar choristomas and upper eyelid colobomas. While the predominant pathological type of epibulbar choristomas overall is dermoid, distinct pathological features have been correlated with their anatomic location or clinical group. Upper eyelid colobomas tended to be located on the inner side, often presenting as mild-to-moderate defects and frequently co-occurring with epibulbar choristomas.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"643-657"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-Based Uveitis Diagnosis Through Retinal Vasculature Analysis: A Paradigm Shift in Ocular Tuberculosis.","authors":"Ikhwanuliman Putera, Jose D Vargas Quiros, Saskia M Rombach, Willem A Dik, P Martin van Hagen, Rina La Distia Nora","doi":"10.1007/s40123-025-01103-4","DOIUrl":"10.1007/s40123-025-01103-4","url":null,"abstract":"<p><strong>Introduction: </strong>Diagnosis of uveitis is complex and often requires a series of investigations. Here, we utilize artificial intelligence (AI) for the quantitative analysis of retinal vasculature parameters from fundus photographs to differentiate confirmed ocular tuberculosis (TB) from QuantiFERON (QFT)-positive uveitis without another identifiable cause and ocular toxoplasmosis.</p><p><strong>Methods: </strong>Medical records and stored fundus images of patients with uveitis from a cohort at the Department of Ophthalmology, University of Indonesia, were analyzed. Three groups of patients were included: confirmed ocular TB (group A), QFT-positive uveitis (group B), and ocular toxoplasmosis (group C). Fundus images were processed using the Retinalysis models package for segmentation and quantification of retinal vasculature parameters.</p><p><strong>Results: </strong>The study included nine patients (13 eyes) in group A, 38 patients (48 eyes) in group B, and 26 patients (39 eyes) in group C. Significant differences were found in vein tortuosity parameter, in the eyes within group A showing lower tortuosity score compared to eyes within group B (p = 0.030) and group C (p = 0.013). The area under the curve (AUC) of vein tortuosity for group A compared to group B was 0.749 (95% confidence interval (CI): 0.606-0.892), with a sensitivity of 67.3% and specificity of 76.9%. The AUC of vein tortuosity for group A against group C was 0.803 (95% CI: 0.658-0.948), with a sensitivity of 74.4% and a specificity of 84.6%. In group A, uveitis resolution and vein tortuosity tended to be normalized upon complete antitubercular treatment.</p><p><strong>Conclusions: </strong>AI-based quantification of retinal vasculature parameters, particularly vein tortuosity, can differentiate confirmed ocular TB from QFT-positive uveitis and ocular toxoplasmosis. This approach shows promise for more precise diagnostic and therapeutic accuracy in ocular TB.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"717-732"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Precision and Clarity with New Digital Color Assistant in 3D Heads-Up Vitreoretinal Surgery.","authors":"Rodolfo Mastropasqua, Alberto Quarta, Maria Ludovica Ruggeri, Leonardo Mastropasqua","doi":"10.1007/s40123-025-01106-1","DOIUrl":"10.1007/s40123-025-01106-1","url":null,"abstract":"<p><strong>Introduction: </strong>To describe the advantages of the ARTEVO^® 850 digital color assistant (DCA) for enhancing visualization during vitreoretinal surgery.</p><p><strong>Methods: </strong>All surgical procedures were conducted under the expertise of a single surgeon utilizing the ARTEVO^® 850 heads-up microscope from ZEISS. During the surgeries, images were contemporaneously recorded with and without the application of the DCA across key phases: core vitrectomy, peripheral vitrectomy, epiretinal membrane (ERM) peeling, and internal limiting membrane (ILM) peeling. This approach enabled a direct comparison to evaluate the impact of the filter on visualization quality during each specific surgical maneuver.</p><p><strong>Results: </strong>The application of the \"vitrectomy blue\" filter on the ARTEVO^® 850 surgical microscope provided advantages, particularly during core and peripheral vitrectomy. The \"vitrectomy blue\" filter improved visualization of the vitreous, allowing for clearer identification and removal of residual vitreous strands and opacities. In surgeries involving ERM, the \"peeling blue\" filter provided enhanced contrast and clarity in visualizing the membrane, facilitating thorough peeling. Furthermore, when used in conjunction with dye staining techniques, it further amplified the visualization of ERM in high myopic eyes. This combination reduced the need for additional re-staining during surgery, streamlining the procedure and potentially minimizing intraoperative complications related to dye toxicity. In macular hole surgery, the \"peeling blue\" filter contributed to improving the characterization and delineation of the hole edges and surrounding tissues.</p><p><strong>Conclusions: </strong>The ARTEVO^® 850 DCA can potentially enhance tissue visualization during vitreoretinal surgeries, particularly in scenarios with compromised visibility. Our observation underscored the efficacy of the blue filter in improving the clarity and contrast of vitreous, ERM and macular hole visualization. This enhancement was particularly evident when the DCA was used in combination with dye staining techniques, which further improved the visualization of ERM in high myopic eyes.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"805-814"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy, Safety, and Injection Frequency with Novel Aflibercept 8 mg in Neovascular Age-Related Macular Degeneration: A Comparison with Existing Anti-VEGF Regimens Using a Bayesian Network Meta-Analysis.","authors":"Piotr Wojciechowski, Marlena Wdowiak, Malgorzata Panek, Izabella Lunk, Joao Carrasco, Xin Zhang, Olivia Wu, Jean-François Korobelnik, Paolo Lanzetta","doi":"10.1007/s40123-025-01098-y","DOIUrl":"10.1007/s40123-025-01098-y","url":null,"abstract":"<p><strong>Introduction: </strong>Aflibercept 8 mg administered in extended dosing intervals has shown non-inferior visual gains and comparable safety profile to aflibercept 2 mg in the PULSAR pivotal randomized clinical trial and has the potential to reduce the treatment burden of treating neovascular age-related macular degeneration (nAMD). This study aimed at gathering robust evidence to assess the comparative efficacy, safety, and treatment burden of aflibercept 8 mg against other anti-vascular endothelial growth factor (VEGF) agents as ranibizumab, brolucizumab, faricimab, and bevacizumab in patients with nAMD.</p><p><strong>Methods: </strong>A systematic literature review (SLR) was conducted, targeting clinical trials of anti-VEGF agents in patients with nAMD. The results of the SLR were included in a network meta-analysis (NMA) comparing aflibercept 8 mg to other anti-VEGF treatments in nAMD, considering a 1-year time horizon. Treatment efficacy was assessed based on the change in best-corrected visual acuity (BCVA) from baseline, the proportion of patients gaining or losing 15 Early Treatment Diabetic Retinopathy Study (ETDRS) letters and changes in anatomical outcomes measured as change in central retinal thickness (CRT) or central subfield thickness (CST). Safety was assessed considering the incidence of ocular and non-ocular adverse events. Treatment burden was defined as the mean number of intravitreal injections over the study period.</p><p><strong>Results: </strong>The base-case NMA involving 21 studies did not show significant differences between aflibercept 8 mg and comparators regarding BCVA change from baseline and proportion of patients with a gain or loss of ≥ 15 letters. On the anatomical endpoints, aflibercept 8 mg was associated with statistically significant improvement in CRT/CST change from baseline compared with ranibizumab in fixed and pro re nata regimens. No significant differences were identified versus the other anti-VEGF. The analysis of the safety outcomes did not identify any significant differences between aflibercept 8 mg and any of the comparators. During the first year of treatment, patients treated with aflibercept 8 mg (following 12- or 16-week injection intervals) received on average 5.9 and 5.1 injections, respectively. For the same period, patients treated with faricimab received from 6.2 to 6.7 injections, patients treated with ranibizumab from 7.62 to 12.14 injections, and patients treated with aflibercept 2 mg up to 7.67 injections.</p><p><strong>Conclusion: </strong>Aflibercept 8 mg demonstrates a comparable efficacy and safety to currently available anti-VEGF treatments for nAMD, with the potential added benefit of requiring fewer injections. These results suggest that aflibercept 8 mg could be a favourable treatment option for nAMD, achieving sustained disease control while alleviating the burden of injections on patients, caregivers, and healthcare providers.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":"733-753"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}